Comments and Conclusions
- CHRPE is generally described as a flat and pigmented lesion at the level of the retinal pigment epithelium (RPE) that is round and darkly pigmented, often surrounded by a halo of hypopigmentation.1 Often the lesions show scalloped edges and have areas of depigmentation within or encompassing the lesion known as lacunae.1 Patients who present with CHRPE are typically asymptomatic like many of the patients in this presentation.
- For a long time CHRPE lesions were considered to be a stable unchanging lesion, but recent research has shown CHRPE lesions to enlarge slowly over time. In one such study where the features and frequency of enlargement was studied in 330 patients, flat enlargement was noted in 83% of patients followed up for 3 or more years, with an average median rate of enlargement of 10μm per month.6
- Rarely, CHRPE lesions may enlarge and develop a nodular appearance. Shields documented five cases where this occurred, one of which progressed to a low-grade adenocarcinoma that appeared clinically and histopathologically to arise from CHRPE.7 Although this is a rare event, they recommended that patients with CHRPE be followed up periodically for possible, though unlikely, evolution of the lesion into a neoplasm.7